Provider Demographics
NPI:1124669965
Name:FELDMAN, CASSONDRA L (PSYD)
Entity type:Individual
Prefix:DR
First Name:CASSONDRA
Middle Name:L
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 KANE CONCOURSE STE 203
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2138
Mailing Address - Country:US
Mailing Address - Phone:305-853-9857
Mailing Address - Fax:
Practice Address - Street 1:1019 KANE CONCOURSE
Practice Address - Street 2:
Practice Address - City:BAY HARBOR ISLANDS
Practice Address - State:FL
Practice Address - Zip Code:33154-2137
Practice Address - Country:US
Practice Address - Phone:395-409-2716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-02
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10552103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical